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Weekly iron and folic acid supplementation and nutrition education for adolescent girls in Africa and Asia

This is a summary of a Field Exchange field article that was included in issue 66. The original article was authored by Anjali Bhardwaj, Lucy Murage, Shibani Sharma, Dhian Dipo, Christine Makena, Marion Roche and Mandana Arabi

Anjali Bhardwaj is the Regional Manager for Adolescents and Women’s Health and Nutrition for Asia at Nutrition International. 

Lucy Murage is the Regional Advisor for Adolescents and Women’s Health and Nutrition for Africa at Nutrition International.

Shibani Sharma is a Junior Technical Officer for the Adolescents and Women’s Health and Nutrition programme at Nutrition International’s headquarters in Ottawa.

Dhian Dipo is Director of Public Health Nutrition at the Directorate General of Public Health, Ministry of Health, Republic of Indonesia.

Christine Makena is a Senior Programme Officer in charge of the Kenya Adolescent Health and Nutrition programme at Nutrition International, Kenya Office.

Marion Roche is the Senior Technical Advisor for Adolescents and Women’s Health and Nutrition at Nutrition International.

Mandana Arabi is Vice President and Chief Technical Advisor for Global Technical Services at Nutrition International headquarters.

Nutrition International has supported governments to develop and implement weekly iron and folic acid (IFA) supplementation and nutrition education to reduce anaemia in six high-risk countries since 2015.

  • Despite regional supply chain challenges and COVID-19 pandemic-related complications, IFA supplementation coverage increased in all countries.
  • A paucity of data on adolescent outcomes continues to restrict the design, implementation and monitoring of adolescent nutrition programmes.
  • Although school-based delivery models are effective at the population level, reaching out-of-school adolescents remains a significant challenge. Governments should prioritise community-based approaches to reach this isolated and often more vulnerable group.

Background 

Since 2015, Nutrition International (NI) has worked with national and subnational governments in six African and Asian countries (India, Indonesia, Kenya, Senegal, Ethiopia and Tanzania) to implement adolescent nutrition programmes under the ‘Right Start’ initiative (2015-2020). Programmes are based on World Health Organization (WHO) recommendations and include weekly iron and folic acid (IFA) supplementation (WIFAS) and nutrition education to reduce anaemia.

Programme description

In each country, NI consulted with the government to develop context-specific strategies for WIFAS and nutrition education. They also collaborated with the government and non-governmental organisations to deliver these programmes.

Across countries, programme development and implementation incorporated:

NI also conducted quantitative and qualitative surveys including baseline, midline and endline assessments. Within NI’s global Nutrition Intervention Monitoring System, a set of uniform survey tools and data collection methodologies was developed. These modules were easily adaptable by context and were implemented in all countries since 2017 with the exception of India where a reliable HMIS system was already in place.

Results/outcomes

Figure 1: Additional1 adolescent girls who consumed the recommended weekly IFA supplements2 by country from 2016 to 2019

Successes, challenges and lessons learned

The WIFAS programmes were successful in supporting governments to create enabling environments and to develop capacity for delivering adolescent nutrition programmes. Successes, challenges and lessons learned during programme development and implementation include:

Conclusion

NI’s experiences demonstrate the successful establishment and scale-up of WIFAS across countries in Asia and Africa. Moving forward, the development of more resilient and adaptable government-supported programmes that feature active engagement and participation from adolescents and their communities is needed to improve the delivery and uptake of adolescent nutrition programmes.

For more information, please contact Anjali Bhardwaj at abhardwaj@nutritionintl.org.

 

Read more...

1 Refers to the additional girls reached due to NI's support for the programme. With the exception of India, the baseline was zero when the adolescent nutrition programmes were initiated in all countries in 2015

2 The recommended scheme of WIFAS refers to 12 tablets in the last six months

3 https://global.learning.nutritionintl.org/index.

4 https://www.nutritionintl.org/wp-content/uploads/2019/04/WIFAS_for_Adolescents_FAQs_2019.pdf

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Anjali Bhardwaj, Lucy Murage, Shibani Sharma, Dhian Dipo, Christine Makena, Marion Roche and Mandana Arabi (). Weekly iron and folic acid supplementation and nutrition education for adolescent girls in Africa and Asia. FEX 66 Digest , March 2022. www.ennonline.net/fexdigest/66/ironandfolicacidnutritioneducation

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